Provider Demographics
NPI:1396858155
Name:CITY OF SEWARD
Entity Type:Organization
Organization Name:CITY OF SEWARD
Other - Org Name:PROVIDENCE SEWARD MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR REIMB ADMIN & ASST SEC ENROLLMT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-525-5392
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-0430
Mailing Address - Country:US
Mailing Address - Phone:907-224-5205
Mailing Address - Fax:907-224-7248
Practice Address - Street 1:417 FIRST AVENUE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-0417
Practice Address - Country:US
Practice Address - Phone:907-224-5205
Practice Address - Fax:907-224-7248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNOT NUMBERED282NC0060X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHS487OPMedicaid
AKHS487IPMedicaid
AKMDG487Medicaid
AKMDG487Medicaid
AKDB2364Medicare UPIN
AKHS487OPMedicaid